Tenecteplase versus streptokinase thrombolytic therapy in patients with mitral prosthetic valve thrombosis

Prosthetic valve thrombosis (PVT) is a dreadful complication of mechanical prosthetic valves. Thrombolytic therapy (TT) for PVT is an alternative to surgery and currently making a leading role. This study compares TT with tenecteplase (TNK) and streptokinase (SK) head to head in patients with mitral...

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Bibliographic Details
Published in:Indian heart journal 2018-07, Vol.70 (4), p.506-510
Main Authors: Kathirvel, D., Justin Paul, Gnanaraj, Prathap kumar, Gorijavaram, Palanisamy, G., Gnanavelu, Ganesan, Ravishankar, G., Swaminathan, N., Venkatesan, Sangareddi
Format: Article
Language:English
Subjects:
Clinical and Preventive Cardiology
Prosthetic valve thrombosis
Streptokinase
Tenecteplase
Thrombolytic therapy
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Summary:Prosthetic valve thrombosis (PVT) is a dreadful complication of mechanical prosthetic valves. Thrombolytic therapy (TT) for PVT is an alternative to surgery and currently making a leading role. This study compares TT with tenecteplase (TNK) and streptokinase (SK) head to head in patients with mitral PVT. In this single center, observational study, patients with mitral PVT diagnosed by clinical data, transthoracic echocardiography, transesophageal echocardiography, and fluoroscopy were included. After excluding patients with contraindications for thrombolysis, they were randomly assigned to receive either SK or TNK regimen. Patients were monitored for success or failure of TT and for any complications. Among 52 episodes (47 patients with 5 recurrences) of mechanical mitral PVT, 40 patients were thrombolyzed with SK and 12 patients were thrombolyzed with TNK. Baseline characteristics including demographic profile, clinical and echocardiographic features, and valve types were not statistically significant between the groups. Complete success rate was 77.5% in SK group and 75% in TNK group (p=0.88). Partial success rate, failure rate, and major complications were not statistically significant between the two groups. Within 12h of therapy, TNK showed complete success in 33.3% of patients compared to 15% in SK group (p-value
ISSN:0019-4832
DOI:10.1016/j.ihj.2017.10.014